| NPI | 1427039072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301056303) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4310156303) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2025-12-11 |